CAJ | 학술논문

目的：探讨改良术前指导在老年人结肠镜检查中的有效性和安全性。方法将120例结肠镜检查前需进行肠道准备的住院老年患者随机分为观察组和对照组各60例，两组患者均在检查前3 d进无渣饮食，检查前1d晚餐进流质饮食，检查当天空腹，服用导泻药物磷酸钠盐口服溶液。观察组以改良术前指导宣教，对照组以传统术前指导宣教，观察患者肠道准备质量、恶心呕吐等不良反应发生情况、血压心率呼吸波动范围情况。结果观察组患者肠道准备质量满意53例，明显高于对照组的40例，差异有统计学意义（χ2＝8．0765，P＜0．01）；恶心、呕吐等不良反应发生率显著低于对照组，差异有统计学意义（χ2值分别为11．1166，13．3308，10．1086，7．5294；P＜0．01）；检查前两组患者血压、心率、呼吸测量结果比较差异无统计学意义（P＞0．05）；检查后观察组患者血压、心率、呼吸测量结果低于对照组，差异均有统计学意义（ P＜0．01）。结论在老年患者结肠镜检查术前准备中改良术前指导更安全、更有效，具有重要临床指导意义。
목적：탐토개량술전지도재노년인결장경검사중적유효성화안전성。방법장120례결장경검사전수진행장도준비적주원노년환자수궤분위관찰조화대조조각60례，량조환자균재검사전3 d진무사음식，검사전1d만찬진류질음식，검사당천공복，복용도사약물린산납염구복용액。관찰조이개량술전지도선교，대조조이전통술전지도선교，관찰환자장도준비질량、악심구토등불량반응발생정황、혈압심솔호흡파동범위정황。결과관찰조환자장도준비질량만의53례，명현고우대조조적40례，차이유통계학의의（χ2＝8．0765，P＜0．01）；악심、구토등불량반응발생솔현저저우대조조，차이유통계학의의（χ2치분별위11．1166，13．3308，10．1086，7．5294；P＜0．01）；검사전량조환자혈압、심솔、호흡측량결과비교차이무통계학의의（P＞0．05）；검사후관찰조환자혈압、심솔、호흡측량결과저우대조조，차이균유통계학의의（ P＜0．01）。결론재노년환자결장경검사술전준비중개량술전지도경안전、경유효，구유중요림상지도의의。
Objective To explore the effectiveness and safety of the improved preoperative guidance on bowel preparation in elderly patients undergoing colonoscopy .Methods One hundred and twenty elderly patients undergoing colonoscopy were randomly divided into the observation group and the control group , each with 60 cases.The patients all received the non-residue diet three days before examination , liquid diet at the dinner one day before examination , fasting at the day of examination , and the sodium phosphate oral solution as the purgation medicine .The observation group received the improved preoperative guidance , and the control group received the conventional preoperative guidance .The quality of bowel preparation , the incidence rates of adverse reactions including nausea and vomiting , and the variabilities in blood pressure , heart rate and respiration were observed .Results The cases of patients who were pleased with the quality of bowel preparation were 53 cases in the observation group , and were significantly higher than 40 cases in the control group , and the difference was statistically significant (χ2 =8.0765, P <0.01 ).The incidence rates of adverse reactions including nausea and vomiting in the observation group were significantly lower than those in the control group , and the differences were statistically significant (χ2 =11.116 6, 13.330 8, 10.108 6, 7.529 4, respectively;P<0.01).No differences were found in the blood pressure , heart rate and respiration before the examination in two groups (P>0.05);The blood pressure, heart rate and respiration in the observation group were lower than those in the control group after the examination, and the difference was statistically significant (P<0.01). Conclusions The improved preoperative guidance is more effectiveness and safety in bowel preparation in elderly patients with colonoscopy , and has important clinical significance .